Kickboxing Membership Form

Begin your membership by filling out this form. Once your form is completed, a representative will reach out to complete the process.

First Name *

Last Name *

Date of Birth *

Gender

Female

Male

Not Specified

I am a: *

Member

Non-Member

Street Address *

City *

Zip Code *

Phone *

Email *

Employer

Work Phone

Monthly Membership:
$105 Club Member | $125 Non-Member

Club Family Membership
2 Members of the same household = $160/month
First add-on $25/month = $185
Second add-on $20/month = $205

Non-Club Family Membership
2 Members of the same household = $180/month
First add-on $35/month = $215
Second add-on $30/month = $245

Monthly Club

Monthly Non-Club

Club Family | 2 Members

First add-on | 3 Members

Second add-on | 4 Members

Non-Club Family | 2 Members

First add-on | 3 Members

Second add-on | 4 Members

Form of Payment

Use credit card on file

Call me for payment information

Name *

Relationship

Phone *

Work Phone